PTCA的新进展

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经皮冠状动脉腔内成形术(PTCA)是治疗冠状动脉粥样硬化病(CAD)的一种机械性的、非手术的疗法。自Andreas Gruentzig于1977年介绍PTCA以来,又出现了数种技术改良使得其临床应用逐渐推广。 早期的球囊导管按现在的标准评价其体积过大,而且是固定的系统,这不便于接近损害部位和非钙化部位。血管成形术的早期实践者已注意到导管阻塞的冠状动脉供应的心肌所能耐受的缺血程度问题,并将球囊压迫时间限制为仅仅几秒钟。但是,现在有了一些腔管系统、新材料、灌注导管,以及一些辅助措施如溶栓疗法、固定模、心肺支持系统,这些都有助于将PTCA应用于适合于做球囊血管成形术的复杂的CAD患者和非稳定型冠状动脉综合征患者。 Percutaneous transluminal coronary angioplasty (PTCA) is a mechanical, non-surgical treatment of coronary atherosclerosis (CAD). Since the introduction of PTCA by Andreas Gruentzig in 1977, there have been several technical improvements that have led to their clinical application. Early balloon catheters, by their current standards, were too bulky and were fixed systems that did not facilitate access to damaged and non-calcified sites. Early practitioners of angioplasty have noticed the degree of ischemia that can be tolerated by the coronary arteries supplied by the ductal obstruction and limited the compression of the balloon to just a few seconds. However, there are a number of luminal systems, new materials, perfusion catheters, and assistive devices such as thrombolytic therapy, stent, and cardiopulmonary support systems, all of which help to apply PTCA to balloon angioplasty Complex CAD patients and patients with unstable coronary syndrome.
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